Penile cancer, or cancer of the penis, is when healthy cells change and grow out of control, forming a mass called a malignant tumor affecting the skin and tissues of the penis. At Aashray, different treatment options like surgeries, medications, therapies are offered to treat penile cancer.
The penis is an external genital male organ. The main functions of the penis are to pass urine and sperm out of
Penile cancer, or cancer of the penis, is when healthy cells change and grow out of control, forming a mass
called a malignant tumor affecting the skin and tissues of the penis. A malignant tumor may eventually grow and
spread to other parts of the body. There are also benign tumors of the penis that are non-cancerous. They may
grow but do not spread to other parts of the body. Penile cancer is rare, but it can be treated if detected
There are various types of penile cancer, including:
Squamous cell carcinoma usually begins on or under your foreskin but can also develop in other parts of your penis.
Melanoma begins in melanocytes, which are melanin-producing cells located in the deepest layer of the epidermis.
Sarcomas develop in the tissues such as blood vessels, muscles, and fat.
People with penile cancer may or may not have all the symptoms and in some cases, one may have similar symptoms but for a different medical condition. So, it is to be noted that the symptoms are not a confirmation of cancer. The symptoms of penile cancer are as follow:
Following are the common causes and risk factors of penile cancer:
Your doctor will recommend tests to diagnose penile cancer based on the factors like the suspected type of
cancer, age, the overall health of the patient, signs, symptoms, and results of initial health checkups or
medical tests. The tests are as follow:
In a biopsy, the doctor takes a small sample of tissue from the penis and sends it to the laboratory to check for cancer cells. It is the sure way to diagnose cancer.
If your doctor believes that cancer has spread deep within the penis then nearby lymph nodes will be checked for cancer. This will help the doctor to determine the stage and grade of cancer.
X-rays, CT scans, MRI, or other scans will be done to check if cancer has spread to other parts of the body.
Penile cancers are also classified in terms of grade and those are determined by how cells looked under the microscope. To determine cancer’s grade, the doctor compares the cancerous tissue with healthy tissue. Healthy tissue usually has many different types of cells grouped together. If cancer looks similar to healthy tissue and contains different cell groupings, it is called "differentiated" or a "low-grade tumor." If the cancerous tissue looks very different from healthy tissue, it is called "poorly differentiated" or a "high-grade tumor." Higher grade penile cancers are more likely to spread to the lymph nodes and may need more intense treatment.
The tumor grade cannot be identified.
Describes cells that look more like healthy tissue cells, called well differentiated.
The cells are somewhat different from healthy cells, called moderately differentiated.
Describes tumor cells that look very different from healthy cells. This is called poorly differentiated or high grade.
Penile cancer is staged using the tumor node metastases (TNM) system.
Using the TNM system, the "T" plus a letter and/or number (0 to 4) is used to describe the size and location of the tumor. Tumor size is measured in centimeters (cm). A stage may also be divided into smaller groups that help describe the tumor in even more detail. This helps the doctor develop the best treatment plan for each patient. Specific tumor stage information is listed below:
T1a: The tumor has not grown into blood vessels, lymph vessels, or nerves and is not high grade or G3.
T1b: The tumor has grown into blood vessels, lymph vessels, and/or nerves and is high grade (G3).
The “N” in the TNM staging system stands for lymph nodes near cancer, called regional lymph nodes. The regional lymph nodes for penile cancer are located in the groin and the pelvis. Lymph nodes in other parts of the body are called distant lymph nodes. Staging places cancers that have spread to regional lymph nodes and cancers that have spread to distant lymph nodes in separate categories. The N in TNM staging only refers to the regional lymph nodes.
If the doctor evaluates the lymph nodes before the biopsy or surgery, based on a physical examination and/or
other tests, the letter “c”, for “clinical” staging, is placed in front of the N. If the doctor evaluates the
lymph nodes after a biopsy or surgical removal of the lymph nodes, which is more accurate, the letter “p”, for
“pathologic” staging, is placed in front of the N. The information below describes the pathologic staging.
3. Metastasis (M)- The “M” in the TNM system describes whether cancer has spread from the penis to other parts of the body, called distant metastasis.
Doctors assign the stage of cancer by combining the T, N, and M classifications.
There are many treatment options available for penile cancer including:
The doctor will recommend a skin cream if the tumor is on top of the skin.
This procedure is effective for the treatment of small lesions.
In case the lesion is bigger, but still about the size of a pea, then the doctor will recommend Mohs surgery. During this procedure, the affected skin is removed one layer at a time until healthy tissue is reached.
Also called cryotherapy or cryoablation. In this procedure, cold gases are passed through a metal probe through a small incision to freeze and destroy the tumor cells.
This procedure is used when the cancer is only on the foreskin.
This is a surgery to remove some or all of your penis.
This surgery is used to remove some or all of the lymph nodes in your groin and/or pelvis.
In radiation therapy, high-energy rays or other such particles are used to destroy cancer cells and inhibit their growth. The following are the types of radiation therapy:
Side-Effects of Radiation Therapy:
In chemotherapy, medications are used to destroy the cancer cells, stop their growth as well as keeping them from dividing and developing new ones. Chemotherapy usually consists of a schedule in which a number of cycles or sets are repeated in a specific time period. There 2 types of chemotherapy and they are as follow:
Chemotherapy for penile cancer is generally given through an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally).
Side-effects depend on the type of the drug, different combinations as well as the dose; however, the following are the general side-effects one may expect post-chemotherapy:
The follow-ups are especially important in cases of cancers to manage side-effects and monitor the overall health, recovery progress as well as check for any signs that cancer has come back. So, follow-up care and active monitoring are essential. These include regular physical examinations, medical tests, specific tests of the penis and the lymph nodes in the groin, chest x-rays or CT scans, and blood tests.
Cancer rehabilitation and survivorship care are recommended, and this could mean any of a wide range of
services that help people regain control over many aspects of their lives and remain as independent and
productive as possible and these services may include physical therapy, career counseling, pain management,
nutritional planning, financial counseling, and/or emotional counseling.
Dr. Ashit Shah is a senior consultant Urologist heading Aashray Urology Institute. After completing his M.B.B.S. and M.S. in General Surgery, he was awarded Diplomate of National Board (D.N.B.) in Genito-Urinary Surgery by the National Board of Examinations, New Delhi. He earned his Diplomate in Laparoscopic Urology from Louis Pasteur University, Strasbourg, France in the year 2006. Dr. Shah has a special interest in Endo-Urology, especially Urolithiasis i.e. Urinary Stone Disease. Having spent more than 27 years in the profession of Urology, he has experience of over 75,000 urological consultations and more than 15,000 surgeries. Being counted amongst the torch bearers of ethical and transparent medical practice in the city of Vadodara, he was conferred ‘Inspiring Urologist Award’ for the year 2019 by The Economic Times.